title: Gastric microbiota is altered in oesophagitis and Barrett's oesophagus and further modified by proton pump inhibitors.
abstract: Gastro-oesophageal reflux can cause inflammation, metaplasia, dysplasia and cancer of the oesophagus. Despite the increased use of proton pump inhibitors (PPIs) to treat reflux, the incidence of oesophageal adenocarcinoma has increased rapidly in Europe and in the United States in the last 25 years. The reasons for this increase remain unclear. In this study, we aimed to determine whether the microbiota of the gastric refluxate and oesophageal biopsies differs between patients with heartburn and normal-appearing oesophageal mucosa versus patients with abnormal oesophageal mucosa [oesophagitis or Barrett's oesophagus (BE)] and to elucidate the effect of PPIs on the bacterial communities using 16S rRNA gene pyrosequencing. Significant differences in the composition of gastric fluid bacteria were found between patients with heartburn and normal oesophageal tissue versus patients with oesophagitis or BE, but in the oesophagus-associated microbiota differences were relatively modest. Notably, increased levels of Enterobacteriaceae were observed in the gastric fluid of oesophagitis and BE patients. In addition, treatment with PPIs had dramatic effects on microbial communities both in the gastric fluids and the oesophageal tissue. In conclusion, gastric fluid microbiota is modified in patients with oesophagitis and BE compared with heartburn patients with normal biopsies. Furthermore, PPI treatment markedly alters gastric and oesophageal microbial populations. Determining whether the changes in bacterial composition caused by PPIs are beneficial or harmful will require further investigation.
authors.affiliation: Department of Molecular Microbiology & Biotechnology, George S. Wise Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv, 69978, Israel.
authors.forename: Itay
authors.initials: I
authors.lastname: Amir
authors.forename: Fred M
authors.initials: FM
authors.lastname: Konikoff
authors.forename: Michal
authors.initials: M
authors.lastname: Oppenheim
authors.forename: Uri
authors.initials: U
authors.lastname: Gophna
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Half
mesh_terms: D001419:Bacteria / Q000145:classification / Q000187:drug effects*; D001471:Barrett Esophagus / Q000382:microbiology*; D016022:Case-Control Studies; D004269:DNA, Bacterial / Q000235:genetics; D004941:Esophagitis / Q000382:microbiology*; D005750:Gastric Juice / Q000382:microbiology; D005764:Gastroesophageal Reflux / Q000382:microbiology; D006801:Humans; D064307:Microbiota; D054328:Proton Pump Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA
chemical_list: D004269:DNA, Bacterial; D054328:Proton Pump Inhibitors; D012336:RNA, Ribosomal, 16S